Brucella Epididymoorchitis : 10 Years of Experience of a Single Center with 42 Cases

Abstract

Objective: We aimed to describe the clinical, epidemiological, and laboratory characteristics of patients with Brucella epididymoorchitis (BEO) and reveal the effectiveness of the treatment options and recurrence rates after treatment. Methods: The information of 42 BEO patients who were followed and treated in a tertiary training and research hospital between January 2013 and January 2023 was accessed by scanning the patient files retrospectively. Epididymoorchitis diagnosis was based on physical examination findings (testicular swelling, pain, rash) and/or by ultrasonography in patients with a standard tube agglutination test (STA) >= 1/160 and a positive rose-Bengal (RB) test or Brucella bacteria growth in blood cultures. Results: Forty-two patients with brucellosis-associated epididymoorchitis were included in the study. STA>1/160, and RB tests were positive in all patients. While the incidence of BEO among all patients was 10.9%, the incidence of BEO among male patients was 16.1%. The rate of unilateral testicular involvement in the patients was 92.86%, and the rate of bilateral testicular involvement was 7.14%. Pain accompanied testicular growth in 66.6% of the patients. Most patients (76.19%) were detected during the acute brucellosis period. Doxycycline (DOK) and rifampicin (RIF) combination was given to 13 patients, DOK and streptomycin (SM) combination to 22 patients, DOK and gentamicin (GEN) combination to 5 patients, and DOK, RIF and SM combination to two patients. The relapse rate was 4.76% in the patient group treated with DOK and RIF; relapse was not observed in the group of patients treated with DOK and aminoglycoside (SM or GEN). Conclusion: BEO is a complication of brucellosis. It can be treated successfully through early diagnosis, appropriate antimicrobial treatment for six weeks, and practices that increase patient compliance with treatment. Treatment combinations containing aminoglycosides are statistically superior in preventing relapses than combinations containing RIF.